buds:Wow Buds,As a 1st time mum then, i was horrified to be advised to stop
breastfeeding for awhile. Yes. Stop breastfeeding. :shock: Can
you imagine my anguish. I too used to work in GP and have seen
my fair share of goings-on which i thought was sufficient to prep me.
How wrong i was. But as the reading increased each time i went for bb's
follow up... i decided i couldn't bear to watch the prick on her heel any
longer... Bb was so used to it after double light photo-therapy and daily
prickings that she simply stuck her heel out automatically after a while.. :lol:
.... for the daily early morning pricks.
Really appreciate that you told me your experience, looks like your 1st bb really got into serious Jaundice which need daily blood test. When I brought my bb for the blood test, the pricking sound on her tiny heel break my heart. I used to prick into other patients' fingers to test for blood (I do it gently on them, none of them cried before), but never seen my own bb cried for it. (Funny is the 2nd time she went for the blood test she just frown abit.)
Hope I can share my accumulate knowledge about Jaundice with the rest of the mums-to-be or new mums with same problem.
Jaundice in Healthy Newborns
Jaundice refers to the yellow color of the skin and whites of the eyes caused by excess bilirubin in the blood. Bilirubin is produced by the normal breakdown of red blood cells.
Normally, bilirubin passes through the liver and is excreted as bile through the intestines. Jaundice occurs when bilirubin builds up faster than a newborn's liver can break it down and pass it from the body. Reasons for this include:
Newborns make more bilirubin than adults do since they have more turnover of red blood cells. A newborn baby's still-developing liver may not yet be able to remove adequate bilirubin from the blood.
Too large an amount of bilirubin is reabsorbed from the intestines before the baby gets rid of it in the stool.
High levels of bilirubin — usually above 25 mg — can cause deafness, cerebral palsy, or other forms of brain damage in some babies. In less common cases, jaundice may indicate the presence of another condition, such as an infection or a thyroid problem.
Types of Jaundice
Physiological Jaundice: (Most common) occurring in most newborns, this mild jaundice is due to the immaturity of the baby's liver, which leads to a slow processing of bilirubin. It generally appears at 2 to 4 days of age and disappears by 1 to 2 weeks of age.
Jaundice of Prematurity: occurs frequently in premature babies since they are even less ready to excrete bilirubin effectively. Jaundice in premature babies needs to be treated at a lower bilirubin level than in full term babies in order to avoid complications.
Breastfeeding Jaundice: jaundice can occur when a breastfeeding baby is not getting enough breast milk because of difficulty with breastfeeding or because the mother's milk isn’t in yet. This is not caused by a problem with the breast milk itself, but by the baby not getting enough to drink.
Breast Milk Jaundice: in 1% to 2% of breastfed babies, jaundice may be caused by substances produced in their mother's breast milk that can cause the bilirubin level to rise. These can prevent the excretion of bilirubin through the intestines. It starts after the first 3 to 5 days and slowly improves over 3 to 12 weeks.
Blood Group Incompatibility (Rh or ABO problems): if a baby has a different blood type than the mother, the mother might produce antibodies that destroy the infant's red blood cells. This creates a sudden buildup of bilirubin in the baby's blood. Incompatibility jaundice can begin as early as the first day of life. Rh problems once caused the most severe form of jaundice, but now can be prevented with an injection of Rh immune globulin to the mother within 72 hours after delivery, which prevents her from forming antibodies that might endanger any subsequent babies.
Symptoms and Diagnosis
Jaundice usually appears around the second or third day of life. It begins at the head and progresses downward. A jaundiced baby's skin will usually appear yellow first on the face, followed by the chest and stomach, and finally, the legs. It can also cause the whites of an infant's eyes to appear yellow.
Since many babies are now released from the hospital at 1 or 2 days of life, it is best for the baby to be seen by a doctor within 1 to 2 days of leaving the hospital to check for jaundice (esp for Caucasians who discharge right after enough resting in hospital). Parents should also keep an eye on their infants to detect jaundice.
If you notice your baby’s skin or eyes looking yellow you should contact your peadiatrician to see if significant jaundice is present.
The seriousness of the jaundice will vary based on how many hours old your child is and the presence of other medical conditions.
Treatments
In mild or moderate levels of jaundice, by 1 to 2 weeks of age the baby will take care of the excess bilirubin on its own. For high levels of jaundice, phototherapy — treatment with a special light that helps rid the body of the bilirubin by altering it or making it easier for your baby's liver to get rid of it — may be used.
More frequent feedings of breast milk or supplementing with formula to help infants pass the bilirubin in their stools may also be recommended. In rare cases, a blood exchange may be required to give a baby fresh blood and remove the bilirubin.
If your baby develops jaundice that seems to be from breast milk, your doctor may ask you to temporarily stop breastfeeding. During this time, you can pump your breasts so you can keep producing breast milk and you can start nursing again once the condition has cleared.
If the amount of bilirubin is high, your baby may be readmitted to the hospital for treatment. Once the bilirubin level drops and the treatment is stopped, it is unlikely that treatment for jaundice will need to be restarted.
Happy Sharing and Reading! Hope this benefit some of you!
:love:
